Iowa High Court Defines Infertility as an Illness Covered by Insurance

DES MOINES —  The Iowa Supreme Court, defining infertility as an illness, ruled Wednesday that a couple are entitled to collect medical insurance benefits to pay for artificial insemination.

The 5-0 ruling upheld a Story County District Court’s decision that Thomas and Jill Witcraft’s health insurance plan with his employer, Sunstrand Corp., covers the treatment of a husband and wife for infertility.

“We think the Witcrafts’ infertility problem is an ‘illness’ as that term is used in the plan, and that the procedure in question is a means of treating this illness,” Justice Louis Lavorato wrote in the opinion.

Lavorato said the terms illness , sickness and disease are synonymous as used in such policies.

Witcraft’s insurance carrier had covered previous, less expensive treatments for infertility, and the couple subsequently had a child. Later, they decided to have another child and the policy paid for an inexpensive insemination procedure that was unsuccessful.

Because the last treatment failed, the Witcrafts’ physician suggested a more complex and expensive procedure as their “only option,” court records said.

Sunstrand then said the insurance claim would not be paid because “the medical services were not performed because of an illness or injury of the patient.”